Provider Demographics
NPI:1518108927
Name:ANTHEM CHIROPRACTIC INC
Entity Type:Organization
Organization Name:ANTHEM CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:T
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-614-6777
Mailing Address - Street 1:10170 S EASTERN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3969
Mailing Address - Country:US
Mailing Address - Phone:702-614-6777
Mailing Address - Fax:702-614-6778
Practice Address - Street 1:10170 S EASTERN AVE STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3969
Practice Address - Country:US
Practice Address - Phone:702-614-6777
Practice Address - Fax:702-614-6778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00660111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty